Milestones in the Medical Cannabis Program
- Germany established the current regulatory framework for its medical cannabis program in March 2017. It replaced a more restrictive program that had been in place for years.
Key Laws and Regulations
- Amendment of the German Narcotic Law, implemented in March 2017
- Narcotics Act
- Medicinal Products Act
- Pharmacy Law
- No centralized registry of patients exists.
- Total imports of flower for pharmacy dispensing were roughly 1,200 kilograms (2,646 pounds) in 2017, 3,000 kilograms in 2018 and 2,500 kilograms during the first half of 2019.
- The retail price of MMJ flower is about $22 (20 euros) per gram, of which half is pharmacy markup and taxes.
Medical Cannabis Products Available in the Market
With marketing authorization:
- Sativex to treat multiple sclerosis.
- Canemes to treat nausea and vomiting in patients undergoing chemotherapy for cancer.
Without marketing authorization:
- Pharmaceutical products such as Marinol can be imported, though the generic version, dronabinol, is locally produced and less expensive.
- Dronabinol preparations.
- Cannabis flower and full-spectrum extracts.
North American Companies in the Market
- Alberta-based Aurora Cannabis.
- Ontario-based Aphria.
- British Columbia-based Wayland, through its joint venture with Demecan.
- Ontario-based Canopy Growth is manufacturing dronabinol through C3, formerly the cannabinoid division of the German firm Bionorica.
Exporting flower or full-spectrum extracts to Germany:
- Canopy Growth.
- Aurora Cannabis.
- Ontario-based Cronos Group.
- British Columbia-based Tilray.
- Ontario-based TerrAscend.
- Germany is the largest medical marijuana market outside North America, exceeding the combined sales of other European nations.
- Until March 2017, access was restricted, with only about 1,000 authorized patients in the country. But things changed that year, creating a significant export opportunity to supply a market that, for the time being, depends exclusively on imported product.
- The current framework authorizes the prescription of different types of products and, in general, requires statutory health insurers to reimburse patients.
- Patients must have a serious condition to qualify. Most MMJ prescriptions are for treating chronic pain. Cannabis should be prescribed only as last resort.
- Patients must apply to receive insurance reimbursement. About two-thirds of reimbursement applications are accepted.
- Three companies recently were selected to grow domestically and will be allowed to cultivate a total of 2,600 kilograms per year for a period of four years (with the possibility of increasing 10% per year, with government approval). The first harvest is expected in late 2020. Until then, imports will be necessary—and could continue after the start of domestic cultivation.